Quality Improvement

For public health to fulfill its important role in ensuring the safety and health of the public, improvements in the quality, performance, and impact of public health agencies must be made. So how does public health begin to improve these areas? One answer is through the use of quality improvement (QI). Quality improvement is an integrative process that links knowledge, structures, processes and outcomes to enhance quality throughout an organization.

QuIPS - Quality Improvement Pointers and Strategies

State-level Quality Improvement Activities

Service Contracting Improvement NewsletterWant to know more about the progress that is being made on the new service contracting process? Look no further…this newsletter provides a monthly update on the progress of the project.

Training - The Iowa Department of Public Health will be implementing important quality improvement processes regarding its service contracting process beginning July 1, 2010. Improvements to this process include the use of a document library (SharePoint). The SharePoint system will be used for the execution of IDPH service contracts, associated amendments, expenditure reports and contractually required reports. Training on this system will be offered in the months of May and June. For more information about training opportunities or for instructions on registering for these opportunities, please see below.

StoryboardsStoryboarding is an organized way of showing the overall process of a QI project. Storyboards use simple, clear statements as well as pictures and graphs to describe a problem, summarize the analysis process while it is under way, describe the solution and its implementation, and display the results and next steps.

Local-level Quality Improvement Activities

Lee County Health Department

As a part of the National Association of County and City Health Officials' (NACCHO) Accreditation and Quality Improvement Demonstration Sites Project, Lee County Health Department (LCHD) focused on the agency's capacity to provide health information to individuals for behavior change within the agency's Maternal Child Health (MCH) Program. LCHD created an information packet for marketing MCH services to medical providers to raise awareness of available services, and link additional families and children to needed healthcare systems. LCHD was recognized in 2009 by the NACCHO Model Practices Program for their unique QI efforts. To learn more about Lee County's MCH QI activities, click on the storyboard link below.

Webinar #1 - Getting Started: Steps to Selecting Your Next QI Adventure (Presented November 23, 2010)During this webinar, Tanya Uden-Holman from the University of Iowa - College of Public Health presented information about how to form quality improvement teams and develop AIM statements.

Webinar #2 - Cause and Effect (Presented December 9, 2010)During this webinar, Tanya Uden-Holman from the University of Iowa - College of Public Health presented information about how to determine the root cause of a problem using a cause and effect diagram. Information was also presented on how to use develop and use a root cause selection matrix to identify areas for improvement.

Webinar #3 - Visualizing Your Process: Flowcharting 101 (Presented December 21, 2010)During this webinar, Tanya Uden-Holman from the University of Iowa - College of Public Health presented information about how to develop different types of flowcharts to illustrate processes. Information was also provided on how to analyze flowcharts to determine areas for improvement.

Webinar #4 - Identifying and Prioritizing Solutions (Presented January 11, 2011)During this webinar, Tanya Uden-Holman from the University of Iowa - College of Public Health presented information about how to prioritize possible solutions and develop solution and effect diagrams. Information on developing force field analysis diagrams and radar charts was also shared.

Local QI Training

In July 2011, quality improvement training was conducted by members of the Public Health Quality Improvement Network. During the training, participants learned about how quality improvement can be applied to public health; the Plan-Do-Check-Act (PDCA) approach to QI; how to describe and apply basic QI tools including flow charts, cause and effect diagrams, force field analysis, and solution and effect diagrams; how to develop AIM statements; and how to manage QI projects.

Public Health Learning Congress (2011)

The Public Health Learning Congress was held April 4, 2011 in Ames, Iowa. This event provided an opportunity for local and state partners to share information about advances in implementing public health standards and applying quality improvement to the field of public health. Two learning tracks were offered over the course of the half-day training; one focusing on accreditation and the other on quality improvement. During the training, speakers shared a variety of information including: an overview of each topic area, examples of tools used to prepare for accreditation and implement quality improvement, and lessons learned regarding the improvement journey.

Featured Sessions- A brief description of each of session and resources (presentation slides and handouts) provided during the session can be found below.

Opening Plenary

Title: Accreditation Preparation: Perspective from a Small Local Public Health Agency

Description: In this opening session, participants were introduced to Gina Frack, administrator of the smallest county to participate in the Public Health Accreditation Boards' Beta test. Ms. Frack described why Norton County, Kansas decided to apply to be a beta test, why a small county can pursue accreditation, and benefits of accreditation for all.

Breakout Sessions

Title: Moving from Striving to Thriving: Norton County's Self-Assessment and What Comes Next!

Description: In this session, participants heard about the specific steps Norton County took to complete the PHAB Beta test self-assessment, lessons learned, how they implemented quality improvement to address one of the criteria, and how they plan to proceed in seeking national accreditation.

Title: Managing Accreditation Preparation Activities: Sharing Tools You Can Use

Description: In this session, participants were introduced to tools helpful in talking about accreditation, tools to track documentation, project management tools, and templates developed after the initial pilot of the Iowa Public Health Standards.

Description: In this session, participants learned about the difference between quality assurance and quality improvement, the importance of quality in public health, and quality improvement models with an emphasis on the Plan-Do-Study-Act (PDSA) cycle.

Description: In this session, participants learned more about how the Quality Improvement Network was formed, the education completed to become a quality improvement (QI) champion, and the role of QI champions in improving public health.

Description: In this session, participants learned about how to assess their department or program's readiness for accreditation. Presenters spoke about gaining leadership support, finding an accreditation coordinator, and assessing potential evidence for completeness. Participants received a draft of a two year and five year plan to use in their own departments. Participants also learned how counties in North Carolina have prepared for accreditation.

Description: In this session, participants will hear how three different health departments formed accreditation teams. Speakers from Hancock County Public Health Services, Dallas County Public Health Nursing, and the Iowa Department of Public Health will share about the structure of their teams, talk about team meetings and team process, and make recommendations about how, or if, they would do it differently!

Description: In this session, participants learned about the results of three quality improvement (QI) projects focused on improving obesity prevention initiatives. Each QI team described their project, explained the steps taken to implement change in their program, and provided overall results.

Closing Plenary

Title: Implementing Quality Improvement in Public Health: Stories from the Field

Description: During this session, participants learned about how one bureau at the Iowa Department of Public Health has begun to build a culture of quality, how a local health department used basic QI tools to assist with the assessment of community health needs, and how QI tools have been applied to regional environmental health planning activities in southeast Iowa.